La Palu, or Malaria

Before I came to Lambarene I had never seen a case of malaria. My first day here I saw 15. It is incredible the time and resources at the hospital that are dedicated to malaria, just a huge percentage of what we do. Then when you imagine how much time and energy it takes for the families to come to the hospital, scrape together money to pay, time off work, worry for everyone involved. It is just an enormous amount of stuff in this country decimated by malaria. Even though we try to give out mosquito nets and tell people to have little ones sleep under them, it still dominates the health care scene here (Unicef article on the current state of the fight against malaria). Briefly, malaria is a parasitical infection caused by one of four main parasites (here is Gabon, mostly falciparum). It enters the blood by the bite of a certain kind of mosquito. Then the parasite multiplies within red blood cells until they are so many that their mass causes the cell to lyse and they all rush into the blood stream causing a fever spike. Each parasite has a specific reproduction cycle length, giving a specific every 48hr, 72hr, or 96hr fever. Malaria also gives headaches, vomiting, loss of appetite, and (possibly) severe anemia. It can also cause neural malaria, which is the worst and deadliest manifestation possible. If I get back to the US and there is a malaria case, I am going to manage it like no body's business. As a sidenote to my medical school compatriots- I had somehow remembered that sickle cell disease is protective against malaria. It is not. Sickle cell trait is (and even then they can still have mild cases). Sickle cell disease gives a terrible malaria with worse anemia than otherwise. A toute a l'heure mes amis.